{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:59:52Z","timestamp":1791165592048,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2009,4,29]],"date-time":"2009-04-29T00:00:00Z","timestamp":1240963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,5,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this randomized study was to compare the results of anal fistula plug and endorectal advancement flap in the treatment of high fistula in ano of cryptoglandular origin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with high trans-sphincteric fistula in ano of cryptoglandular aetiology were randomized to treatment with either an anal fistula plug or endorectal advancement flap. Patients agreed to participate in a follow-up programme, which included scheduled visits at 2, 4, 8, 12 and 24 weeks and at 1 year after surgery. The primary endpoint was effectiveness in fistula healing. Recurrence was defined as the presence of an abscess arising in the same area, or obvious evidence of fistulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A large number of recurrences in the fistula plug group led to premature closure of the trial. After 1 year, fistula recurrence was noted in 12 of 15 patients treated with an anal fistula plug compared with two of 16 treated with an endorectal advancement flap (relative risk 6\u00b740 (95 per cent confidence interval 1\u00b770 to 23\u00b797); P &amp;lt; 0\u00b7001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Contrary to other published studies, an anal fistula plug was associated with a low rate of fistula healing, particularly in patients with a history of fistula surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.6613","type":"journal-article","created":{"date-parts":[[2009,4,29]],"date-time":"2009-04-29T08:14:55Z","timestamp":1240992895000},"page":"608-612","source":"Crossref","is-referenced-by-count":130,"title":["Randomized clinical trial of anal fistula plug<i>versus<\/i>endorectal advancement flap for the treatment of high cryptoglandular fistula<i>in ano<\/i>"],"prefix":"10.1093","volume":"96","author":[{"given":"H","family":"Ortiz","sequence":"first","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Marzo","sequence":"additional","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Ciga","sequence":"additional","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Oteiza","sequence":"additional","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Armend\u00e1riz","sequence":"additional","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"de Miguel","sequence":"additional","affiliation":[{"name":"Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Universidad P\u00fablica de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,4,29]]},"reference":[{"key":"2021070906300836700_bib1","first-page":"725","article-title":"Anal fistula plug: initial experience and outcomes","volume":"50","author":"Safar","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib2","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10350-005-0288-1","article-title":"Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas","volume":"49","author":"Johnson","year":"2006","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib3","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s00268-008-9504-1","article-title":"Early experience with bioabsorbable anal fistula plug","volume":"32","author":"Lawes","year":"2008","journal-title":"World J Surg"},{"key":"2021070906300836700_bib4","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1007\/s10350-008-9374-5","article-title":"Treatment of complex anal fistulas with the collagen fistula plug","volume":"51","author":"Christoforidis","year":"2008","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib5","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1007\/s10350-006-0755-3","article-title":"Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up","volume":"49","author":"Champagne","year":"2006","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib6","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1007\/s10350-006-0695-y","article-title":"Efficacy of anal fistula plug in closure of Crohn's anorectal fistulas","volume":"49","author":"O'Connor","year":"2006","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib7","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1007\/s10350-007-0298-2","article-title":"Anal fistula plug for closure of difficult anorectal fistula: a prospective study","volume":"50","author":"van Koperen","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib8","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1007\/s10350-007-9191-2","article-title":"Collagen fistula plug for the treatment of anal fistulas","volume":"51","author":"Ky","year":"2008","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib9","article-title":"To determine the efficacy of anal fistula plug in the treatment of high fistula-in-ano\u2014an initial experience","author":"Garg","year":"2008","journal-title":"Colorectal Dis"},{"key":"2021070906300836700_bib10","article-title":"Efficacy of the anal fistula plug in complex anorectal fistulae","author":"Thekkinkattil","year":"2008","journal-title":"Colorectal Dis"},{"key":"2021070906300836700_bib11","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s00384-007-0398-4","article-title":"Initial experience on efficacy in closure of cryptoglandular and Crohn's transsphincteric fistulas by the use of the anal fistula plug","volume":"23","author":"Schwandner","year":"2008","journal-title":"Int J Colorectal Dis"},{"key":"2021070906300836700_bib12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.cursur.2006.07.005","article-title":"Bioprosthetic plug for complex anal fistulas: an early experience","volume":"64","author":"Ellis","year":"2007","journal-title":"J Surg Educ"},{"key":"2021070906300836700_bib13","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1046\/j.1463-1318.2002.00359.x","article-title":"Accuracy of hydrogen peroxide-enhanced ultrasound in the identification of internal openings of anal fistulas","volume":"4","author":"Ortiz","year":"2002","journal-title":"Colorectal Dis"},{"key":"2021070906300836700_bib14","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1046\/j.1365-2168.2000.01582.x","article-title":"Endorectal flap advancement repair and fistulectomy for high trans-sphincteric and suprasphincteric fistulas","volume":"87","author":"Ort\u00edz","year":"2000","journal-title":"Br J Surg"},{"key":"2021070906300836700_bib15","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1002\/bjs.6023","article-title":"Length of follow-up after fistulotomy and fistulectomy associated with endorectal advancement flap repair for fistula in ano","volume":"95","author":"Ortiz","year":"2008","journal-title":"Br J Surg"},{"key":"2021070906300836700_bib16","first-page":"725","article-title":"Short-term results in the treatment of anal fistulas with Surgisis\u00ae AFP","volume":"50","author":"Ky","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib17","first-page":"749","article-title":"Anal fistula plug (AFP\u2122) for the treatment of fistula in ano","volume":"50","author":"Abbas","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib18","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1007\/s10350-004-7249-y","article-title":"Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal advancement flap","volume":"45","author":"Sonoda","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib19","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/BF02235039","article-title":"Transanal advancement flap repair of transsphincteric fistulas","volume":"42","author":"Schouten","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib20","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S1091-255X(97)80138-2","article-title":"Endorectal mucosal advancement flap: the preferred method for complex cryptoglandular fistula-in-ano","volume":"1","author":"Golub","year":"1997","journal-title":"J Gastrointest Surg"},{"key":"2021070906300836700_bib21","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/BF02048261","article-title":"Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal\/vaginal fistulas","volume":"39","author":"Ozuner","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib22","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/BF02554093","article-title":"Mucosal advancement in the treatment of anal fistula","volume":"28","author":"Aguilar","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"2021070906300836700_bib23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1463-1318.2007.01423.x","article-title":"The Surgisis AFP anal fistula plug: report of a consensus conference","volume":"10","year":"2008","journal-title":"Colorectal Dis"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.6613","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/96\/6\/608\/36652047\/bjs6613.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/96\/6\/608\/36652047\/bjs6613.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:47:53Z","timestamp":1710290873000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/96\/6\/608\/6148432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,29]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2009,4,29]]},"published-print":{"date-parts":[[2009,5,11]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.6613","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2009,6]]},"published":{"date-parts":[[2009,4,29]]}}}